Week 8 - Sexual Dysfunctions, Paraphilic Disorders and Gender Dysphoria Flashcards
(42 cards)
Incest
In general, viewed negatively (linked to biology)
However - royalty in history, may have been necessary in small communities
Homosexuality history
Ancient Rome/Greece - often accepted + power dynamics
Early Christianity - Catholic church, sex only for procreation
Late Medieval - Secular law punishes sodomy
Homosexuality and American psychiatry
Kinsey finds homosexuality more common (can’t different gay and straight on test results)
Included in DSM-I (cultural norms, mental illness rates)
Masters & Johnson show sexuality as diverse
Gay Liberation movement (60s) leads to it being removed from DSM-III (had ‘sexual disorder NOS’)
Homosexuality and Australia
Gradual decriminalisation, same sex marriage legalised in 2017
Census doesn’t capture sexual minorities
National survey - 3.5% identify as sexual minority (much more in young people - societal influence)
NZ survey - people describe their own sexuality over 50 ways (6 main - straight, gay, bisexual, bicurious, pansexual, asexual)
Homosexuality - cultural differences
Sambia people (PNG) - rejecting homosexuality would be abnormal
Masturbation
Graham crackers and Kelloggs cornflakes intended to suppress sexual urges
Australian teens and sexual behaviour
Years 10-12 - half done oral sex and 1/3 penetrative (majority 1 partner)
Many had engaged in unwanted sex (drugs, alcohol, pressures)
Sexual response cycle
Sexual pleasure cycle - wanting (cues in environment trigger) > liking > learning (but learning happens at all stages)
Sexual response cycle - sexually incentive stimuli triggers cycle (can be minutes to hours)
- desire > arousal > plateau > orgasm > refraction
Key differences in cycle - women (desire and arousal together or even arousal first), men and women have different orgasms
Sexual abnormality
Consider - time period, culture and social influences, normative statistics, biology, gender differences
Sexual dysfunction rarity
41% of women, 31% of men (not rare)
Disorder only diagnosed if distress present (less than 1/4)
Categories of dysfunction
Interest/desire/arousal - female arousal disorder, male hypoactive desire disorder, erectile disorder
Orgasm - female orgasmic disorder, premature ejaculation, delayed ejaculation
Sexual pain - genito-pelvic pain/penetration disorder
Male hypoactive sexual desire disorder
A. Deficient sexual thoughts or desire for sex
B, C, D. 6+ months, clinically sig. distress, not otherwise explained
Relationship stress often co-occurs but cannot be cause
Female sexual interest/arousal disorder
A. Lack of arousal, 3+:
- reduced sex, reduced fantasies, reduced initiation, reduced pleasure, reduced response to cues, reduced genital sensation
B, C, D. 6+ months, clinically sig. distress, not otherwise explained
Erectile disorder
A. 1+ of the following 75-100% of the time:
- difficulty obtaining erection, difficulty maintaining erection, decreased rigidity
B, C, D. 6+ months, clinically sig. distress, not otherwise explained
Female orgasmic disorder
A. 1+ of the following 75-100% of the time:
- Delay/absent orgasm, reduced orgasm intensity
B, C, D. 6+ months, clinically sig. distress, not otherwise explained
Premature ejaculation disorder
A. Pattern of ejaculation within 1 minute of sex
B, C, D. 6+ months AND 75-100% of the time, clinically sig. distress, not otherwise explained
Delayed ejaculation disorder
A. 1+ of the following 75-100% of the time:
- Delay in ejaculation, infrequent ejaculation
B, C, D. 6+ months, clinically sig. distress, not otherwise explained
Genito pelvic-pain/penetration disorder
A. Difficulties with 1+:
- vaginal penetration, pain during sex, fear/anxiety about pain, tensing of pelvis during sex
B, C, D. 6+ months, clinically sig. distress, not otherwise explained
Dysfunction predictors
Biological - smoking, drinking, heart issues, diabetes, neurological issues, low mental arousal, SSRIs, antihypertensive medication, drugs
Sociocultural - erotophobia, rape, relationship problems, long abstinence, history of hurried sex
Psychological - depression, anxiety, low SE, poor environment for sex, narrow sex attitudes, performance fears, spectator role, routine dependent
Dysfunction treatment
Education very effective
Couples therapy (if relationship problems)
Communication training
Masters and Johnson sensate focus training:
- I - no sex, just kissing
- II - genital touching, but no orgasm
- IIIA - penetration but limited
- IIIB - full sex
Medications not consistently helpful for women
Specific treatments:
Premature ejaculation (squeeze technique), female orgasm (masturbation training), vaginismus (dilators), low desire (exposure to erotic material)
Erectile dysfunction - viagra (headaches), penis injection, vacuum, implants
Paraphilic disorders
Misplaced sexual attention (inappropriate people/objects)
Only disordered if clinically sig. distress OR non-consenting person involved
No prevalence statistics
High comorbidity with anxiety, mood, substance disorders
Mostly in males, mostly starts in adolescence (sadism and masochism in adulthood)
Frotteuristic disorder
Arousal from touching/rubbing against non-consenting person
Fetishistic disorder
Arousal from non-living objects or specific non-genital body parts
Voyeuristic disorder
Arousal from observing unsuspecting person naked, derobing or having sex (person must be 18+)
